Opinions - Zoloft (sertraline) for depression?

[csharpprogrammer]

SWIM was recently prescribed the SSRI Zoloft (sertraline HCl) for his "Depression". SWIM is also prescribed Ativan (lorazepam), Tegretol (carbamazepine), and Inderal (propranolol). SWIM is diagnosed Bipolar NOS with suicidal ideations. Do you think SWIM should follow the new treatment and take the Zoloft as prescribed? He is a little sceptical about the SSRIs.

[Heretic.Ape.]

I would say it's usually a good idea to go along with one's doctors recommendations. Bipolar people stopping taking their meds is a very common problem (labmonkey doesn't take his because he'd rather be crazy than feel nothing) and is considered one of the main dangers in bipolar disorder. It would likely be a good idea to stay on antidepressants until suicidal ideation is under control. Monkey gets suicidal ideation but has established a deeply rooted safeguard that suicide is simply not an option and that the depression will cycle back to normality and (if lucky ) some lovely hypomania, whee.

Reputation Comments on this post:

Thanks for the good feedback.

[Aztec077]

I usually agree with Doctor's recommendations. But when it comes to taking psych meds, it's a very sticky situation for me at least. To the point where I don't know if this forum needs to know my opinions on psych meds. Being cautious at this point. But I agree with what was mentioned above.

[kinai]

If you end up taking Zoloft, if you ever decide to not take it anymore, come off it slowly. SWIM took it for depression and anxiety for only a month or two and decided to stop "cold turkey". As a result SWIM felt nauseated for almost a week and couldn't go to sleep because SWIM had so much sexual desire.. SWIM still has trouble sleeping and it's been probably a month after stopping zoloft - anyone else experience anything similar?

[mrsg84]

Selective serotonin reuptake inhibitors are the kind most used these days. And that's because they have mild (to no) side effects and are tolerated well. I have been prescribed Zoloft in the past (for severe depression) and it really did help me; the only side effect I experienced was some dry mouth but that's nothing.

[Jatelka]

^^^ While SSRI's are helpful to some to state that they "have mild (to no) side effects" is false and unhelpful.

SSRI antidepressants have been shown to increase the risk (compared to placebo) of suicidal thinking in children, young people and adults in short-term studies of major depressive disorder.

They are also well recognised to cause other adverse effects, including sexual dysfunction (14% ejaculation failure with sertraline, compared to 1% with placebo), dependence and an associated withdrawal syndrome, potentially life-threatening serotonin syndrome when combined with other serotonergic drugs (including Tramadol, DXM, St John's Wort, migraine drugs and MDMA among many others). SSRI's also have a potentially life-threatening interaction with drugs with MAOI activity.Sertraline has been shown to increase the risk of Upper GI Bleeding in people who take NSAIDs, Aspirin and COX 2 inhibitors, they are also a well recognised cause of hyponatraemia, which can cause confusion and seizures.

Sertraline has also been reported to be fatal in (mono) overdose, with at least 8 deaths being reported in the literature

I could go on...

Any drug is a balance of risk and benefit, but SSRI's are not the benevolent panacea that big pharma would have us believe. Bear in mind also, that trials reporting efficacy have only been over 12 weeks

[mrsg84]

Of course there are risks as there are risks to every drug on the planet, but my point was they have considerably less side effects than MAOIs or older antidepressants. Zoloft, as discussed in particular, also isnät on the list of those SSRIs most known to aggrevate suicidal behavior.

And the list of interactions and overdose possibilities is pointless, you can OD with virtually all drugs. No one tells you to take Zoloft and MAOIs and St John's wort at the same time.

My point was that SSRI's are better compared to other options. And it's no use to list all the crap, it's only going to discourage the person suffering from depression.